From the Guidelines
Juvenile arthritis does not always go away completely, but with proper treatment, many children can achieve remission. The disease may persist into adulthood, causing ongoing significant morbidity and impaired quality-of-life 1. According to the 2019 American College of Rheumatology guideline, all forms of JIA are associated with decreased health-related quality of life and risk for permanent joint damage 1.
Treatment and Outcomes
Treatment typically involves medications such as non-steroidal anti-inflammatory drugs (NSAIDs), systemic and intraarticular glucocorticoids, and non-biologic and biologic disease modifying antirheumatic drugs (DMARDs) to control inflammation and prevent joint damage 1. Prompt initiation of appropriate therapy is of critical importance in preventing permanent damage and improving outcomes. The course of JIA varies greatly depending on the subtype, with oligoarticular JIA generally having a better prognosis than polyarticular or systemic forms.
Disease Management
Even during periods of remission, regular monitoring is necessary as flares can occur, especially during times of stress, illness, or hormonal changes like puberty. The goal of treatment is to achieve inactive disease or clinical remission, allowing normal growth, development, and quality of life. About 40-60% of children with JIA will eventually outgrow the condition or achieve long-term remission, while others may continue to have symptoms into adulthood. Early and aggressive treatment improves outcomes significantly, and physical therapy is also important to maintain joint mobility and strength.
From the Research
Juvenile Arthritis Overview
- Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease that affects children, and its treatment typically involves non-steroidal anti-inflammatory drugs or disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate or sulfasalazine 2, 3.
- The disease can be managed with various treatments, including biologic agents, and the goal is to improve symptoms and quality of life.
Disease Progression and Treatment
- While some patients may experience remission, JIA can be a lifelong condition, and patients often need to continue treatment into adulthood 4.
- Treatment options have improved over the years, with the development of new therapeutic agents, including biologic agents and small molecules 2, 3.
- Disease-modifying antirheumatic drugs (DMARDs) have been shown to improve outcomes compared to conventional therapy, and continued treatment can decrease the risk of flares 5.
Long-term Management
- Most JIA patients need to transition from pediatric to adult rheumatology care to continue managing their disease and receiving adequate long-term treatment 4.
- Transitional care is critical to ensure that patients receive consistent and effective treatment, but obstacles such as lack of specific criteria for disease activity assessment and poor adolescent-specific training for adult rheumatologists can hinder the success of this transition 4.
- Physical activity and sports participation are also important for children with JIA, and while evidence supports physical activity, there is limited guidance on the recommended approach 6.